Postnatal disclosure of domestic violence: comparison with disclosure in the first trimester of pregnancy

Abstract

AIMS AND OBJECTIVES: This study explored the prevalence rates of domestic violence reported during the first trimester of pregnancy and in the postnatal period. BACKGROUND: Domestic violence is known to have a deleterious effect on the physical and psychological well-being of a woman, with an adverse effect on the unborn child. DESIGN: A validated anonymous and self-administered questionnaire (Abuse Assessment Screen) using five closed questions was used for data collection in all samples. All women were approached alone, and the questionnaire was completed in private. METHOD: Drawn from the same geographical area, this survey collected data from women accessing hospital clinics, in a large university teaching hospital in the UK. RESULTS: Comparing self-reporting rates of domestic violence in the first trimester of pregnancy to the postnatal period yielded statistically significant results (p < 0·01). Only 7·3% booking-in clinic and 8% postnatal women reported violence at some stage in their life, whilst higher rates in pregnancy counselling clinic (35·1%) and early pregnancy unit (26%) were reported. However, the reported rates of domestic violence in the year before the women were pregnant revealed a different trajectory. Lower rates of domestic violence were evident in three samples. CONCLUSIONS: The disparity in disclosure rates of domestic violence suggests that an emotional inhibitory response to disclosure may occur at specific periods of pregnancy and that the timing of asking about domestic violence may be critical to this disclosure. The pandemic nature of domestic violence reflects the need for practice in maternity care to reflect the changing needs of a woman during her gestational experience. RELEVANCE TO CLINICAL PRACTICE: The primary objective of health care providers should be to engage a pregnant woman in a meaningful relationship, gaining her trust to facilitate the disclosure of domestic violence. Hence, whatever the policies for the provision of maternity care, the changing needs of a pregnant woman must be met.

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